Some States Say Declaring An Emergency Has Helped In The Opioid Fight

After a briefing Tuesday on the opioid crisis, President Trump remarked on its severity but did not offer many specifics on tackling the problem. Two days later, he said his administration would declare a national emergency.

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Originally published on August 10, 2017 4:47 pm

Update 3:35 pm August 10: Two days after making a few general remarks about the opioid crisis, President Trump on Thursday called it "a national emergency" and said his administration would be drawing up papers to make it official.

"We're going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis," Trump told reporters at his golf club in Bedminster, N.J.

Just two days ago, Health and Human Services Secretary Tom Price said such a declaration is usually reserved for "time-limited" problems such as the Zika outbreak and that the administration believed they already had the resources and focus needed to tackle the problem. But he did add that "all things are on the table for the president."

Trump's commission on opioids, chaired by New Jersey Gov. Chris Christie, had recommended that the president declare a national emergency in its interim report last week. The report also recommended increasing access to addiction treatment and to naloxone, the drug that can reverse an overdose.

While there has been debate among addiction treatment specialists over what a national emergency declaration would achieve, a handful of states have found the move helpful. The health news website STAT reports that six states have used disaster or emergency declarations in order to take more aggressive measures to fight opioids.

Arizona Republican Gov. Doug Ducey signed an emergency declaration in June, after the state reported that 790 Arizonans had died from opioid overdoses in 2016, an average of more than two per day.

"What this does is allows us to use additional resources — so additional funding, additional personnel," Dr. Cara Christ, director of the Arizona Department of Health Services, told All Things Considered host Audie Cornish.

With the emergency declaration, Christ says the state has been able to train law enforcement on the use of naloxone, which helps reverse overdoses, and develop opioid prescribing guidelines.

They've also gotten access to better real-time data about the epidemic, including the number of overdose deaths by county and the number of doses of naloxone administered outside of hospital settings. Previously, Christ says, there was a lag of 6 to 18 months in data reporting, which made responding to the crisis harder.

Asked about the renewed emphasis on law and order in dealing with the crisis, including from President Trump himself, Christ says she does see an important role for law enforcement in addressing the illegal supply of drugs. Still, she says, it's important to treat drug addiction as a chronic disease rather than a crime.

"We don't want people to feel afraid of going and seeking help and calling in the middle of an emergency," she says. "You wouldn't hesitate in calling when someone has a heart attack. You should call when somebody has a drug overdose and help that friend or loved one get into treatment."

In his remarks Tuesday, Trump noted that the best way to prevent addiction and overdoses is to keep people away from drugs in the first place.

"If they don't start, they won't have a problem," he told reporters. "So if we can keep them from going on and maybe by talking to youth and telling them, 'No good. Really bad for you in every way.' But if they don't start, it will never be a problem."

Christ says what's so challenging about the opioid epidemic in the U.S. is that most people never started out intending to use illicit drugs.

"These were drugs that were started as being prescribed by their physician to treat pain or a medical condition or after surgery," she says. "So we really need to work with our health care providers to prevent people from becoming dependent and addicted."

All Things Considered editor Jessica Deahl contributed to this story.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

AUDIE CORNISH, HOST:

President Trump is turning his attention to the nation's opioid crisis. He spoke yesterday laying out plans to step up law enforcement.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT DONALD TRUMP: Federal drug prosecutions have gone down in recent years. We're going to be bringing them up and bringing them up graphically.

CORNISH: Meanwhile, a White House commission studying the opioid epidemic recommends a different approach, framing the issue as a public health crisis focused on prevention and treatment. We wanted to know what this all means for states navigating the issue, so we reached out to Dr. Cara Christ. She's the director of Arizona's Department of Health Services. Her state had almost 800 opioid-related deaths last year, prompting the governor to declare a state of emergency. I asked Dr. Christ how she and her department are approaching the situation.

CARA CHRIST: I think what the health care community and public health community is trying to do, especially in Arizona, is to reverse the stigma associated with drug addiction. This is a chronic health condition. Opioid use disorder is just like any other chronic disease - like diabetes, like hypertension - and needs to be treated in the same manner.

There is treatment available. There are providers that are experts in treating this disease. And we don't want people to feel afraid of going and seeking help and calling in the middle of an emergency. You wouldn't hesitate in calling when someone has a heart attack. You should call when somebody has a drug overdose and help that friend or loved one get into treatment.

CORNISH: I know public health officials for a long time have talked about trying to reduce the stigma around opioid abuse in order for people to be more comfortable to come forward to get treatment. But do you think that's happening? Is that the direction you see the national conversation going?

CHRIST: So we did a survey, and 4 out of 10 people surveyed actually had a loved one or a friend that was addicted to painkillers or opioids. And we know that our communities are so interconnected now that even if you don't have a personal relationship, you're going to be impacted at your workplace, on your roadways, at your children's school. And I think as people are starting to see how prevalent this is, I think we are starting to change the stigma associated with this epidemic.

CORNISH: I grew up with the Say No To Drugs campaign (laughter) and with law enforcement and law and order being an important component to fighting the crack and cocaine epidemic. Are we seeing the same thing happen here, where there's being - where there's going to be renewed emphasis on the law enforcement part of dealing with the drug epidemic?

CHRIST: I think law enforcement plays a part when you're dealing with the illegal supply of drugs. I think what's so challenging about the opioid epidemic in the United States is that most people never intended to try what they consider to be an illicit drug. These were drugs that were started as being prescribed by their physician to treat pain or a medical condition or after surgery. And we know that 4 out of 5 new heroin users started as prescription drug users. So we really need to work with our health care providers to prevent people from becoming dependent and addicted on these medications.

CORNISH: What's your response to people who say, I've been hearing about this as a crisis for a couple years now? And people keep saying, we need more treatment. We need more help. But there are people out there who are listening who think maybe we just need to step in, to be more aggressive about prosecutions and cracking down.

CHRIST: You know, I think that this has been a longtime crisis that has been building over decades. And so I think it's going to take us a while to work our way back out of this issue. And I do believe that on all fronts we need to be more aggressive to address it, really stepping up our public health efforts, getting our prescribers and our providers to assist with this epidemic, to become waivered physicians, to provide treatment, and to really increase access for our patients to receive the care they need.

CORNISH: So be patient is your answer.

CHRIST: This isn't going to be an issue that's going to be solved overnight. It's going to take time. So yes, while we are being as aggressive as we can, it is going to require patience.

CORNISH: That's Dr. Cara Christ, director of Arizona's Department of Health Services. Thank you for speaking with ALL THINGS CONSIDERED.